Introduction

With the introduction of PRISM, some of the specific treatment cases will have to be recorded differently in MedITEX. Specifically, the case of same sex male couple using a donor and a surrogate.

 

The cycle in which eggs are treated needs to be reported with intended father’s details (new PRISM rules). As it is currently not possible to record cycles in male records in MedITEX, we have decided that in such case a dummy female patient has to be created and partnered with intended farther.

 

Couple creation: intended father with female dummy patient

You can use patient group (can be defined in system settings) and/or patient status to help identifying the intended father when opening his patient file. 

Link a female dummy patient as partner to the intended father.

We suggest to create the female dummy patient with:

• same name of male with extension e.g. '_DUMMY'
• same Patient ID as male with extension e.g. '_DUMMY'  (there is a user right to edit patient ID – and a specific patient ID creation rule, which allows edit the patient ID immediately)

Leave the registration type of the DUMMY empty!

Please note: it is necessary that the registration type of the intended father is correctly filled and that the registration type of the dummy stays empty in order that MedITEX triggers (ONLY) the registration form of the intended father and that the cycle forms are triggered for the intended father and not for the dummy.

Possible functions can help identifying the dummy easily: patient group patient status patient picture (e.g. white picture with written "DUMMY patient")

The donation info should only be done for the dummy (the man should NOT be a sperm donor – only if he really donates sperm). For the female dummy, check

• "Person needs: Donor (Ooc./Emb.)" and
• "Person needs: Surrogate mother". 

 

Reservation of donor and surrogate mother

From DUMMY patient side

• reserve an egg donor or frozen eggs of a donor
• reserve/link a surrogate mother

Fresh egg donation

Create a cycle for the egg donor with

• Treatment "Only aspiration"
• Main reason "Egg donation only"
• Activate "Donation"

 

Donate the eggs to the dummy patient. 

 

The HFEA Form "Treatment Cycle" will automatically have field 68. Treatment type filled with “Egg Donation Only”. Treatment feature is taken from the stimulation medication of the donor. 

 

Cycle of intended father and dummy patient

Create a cycle with

• Treatment "Only reception"
• Leave "Main reason " empty
• Activate "Recipient cycle"

 

The HFEA Treatment Cycle form will be triggered automatically for the intended father.

 

The mixing takes place in the cycle of the intended father and the female dummy.

 

HFEA – Form "Embryo Creation And Use": Fill field 123 and field 126 (donor know) with N or Y (send this form when everything is completed in the culture section in MedITEX IVF).

 

Surrogacy

Create a cycle for the surrogate mother with

• Treatment "Only reception"
• Leave "Main reason " empty
• Activate "Surrogacy"

 

The intended father cycle has to be changed to "Embryo transfer to surrogate mother". Surrogate cycle has to be linked and embryo transferred to the surrogate mother cycle. 

 

With the embryo tranfer to the surrogate mother, the HFEA form "Fresh Donated Embryo" is created for the surrogate mother. 

 

Advantages

In comparison to previous process, embryo mixing and storing on either donor or surrogate side, which was necessary to get the data into old EDI, there are some advantages with the new process.

• There is no need to declare the man as sperm donor like it was in the past. So he or his cryo sperm will not show up when searching for a donor.
• Embryos belonging to the intended father are not stored on donor or surrogate side.
• When opening the patient file of the intended father the user can immediately see how many mixing cycles the man has and how many eggs or embryos he has in storage. 

 

Frozen embryo transfer

In order to link/reserve a cryopreserved embryo for a surrogate mother you need to declare the dummy as "Is: Donor (Ooc./Emb.)" and activate the cryo sample "For donation". 

 

Declare the surrogate mother as "Needs: Donor (Ooc./Emb.)" and reserve the embryo for her. 

 

 

Create a cycle for the surrogate mother with:

• Treatment "Thaw cycle"
• Activate "Embry thawing"
• Main reason "FET"
• Activate "Surrogacy"

 

Thaw the reserved embryo in the surrogate’s cycle. 

 

Continue as usual.